摘要
目的探讨微创注入肺表面活性物质(LISA)技术在新生儿呼吸窘迫综合征(NRDS)治疗中的应用价值。方法选择西电集团医院新生儿科监护病区(NICU)2017年1月至2019年3月收治的80例NRDS患儿为研究对象,根据随机数表法将患儿分为观察组和对照组,每组40例,对照组应用气管插管-注入肺表面活性物质(PS)-拔管后-经鼻持续气道正压通气(INSURE)技术治疗,观察组则应用LISA技术治疗,比较两组患儿给药过程中经皮血氧饱和度(SpO2)下降和心动过缓的发生率,以及治疗后再次应用PS、72h内机械通气的比例;记录患儿的病死率以及气胸、支气管肺发育不良(BPD)的发生率。结果观察组患儿在给药过程中SpO2下降和心动过缓的发生率分别为17.5%、7.5%,明显低于对照组的50.0%和27.5%,差异均有统计学意义(P<0.05);观察组患儿治疗后再次机械通气的比例及BPD发生率分别为15.0%和7.5%,均明显低于对照组的35.0%和20.0%,差异均有统计学意义(P<0.05);观察组患儿的再次使用PS率、气胸发生率及病死率分别为37.5%、7.5%、5.0%,与对照组的45.0%、12.5%、7.5%比较差异均无统计学意义(P>0.05)。结论LISA技术应用于新生儿呼吸窘迫综合征的治疗可以有效降低机械通气率及BPD的发生率,具有较高的临床应用价值。
Objective To investigate the value of less invasive surfactant administration (LISA) in the treatment of neonatal respiratory distress syndrome (NRDS). Methods A total of 80 children with NRDS were selected as subjects, who were admitted to the neonatal intensive care unit (NICU) at China XD Group Hospital from January 2017 to March 2019. According to the random number table method, the children were divided into observation group and control group, with 40 cases in each group. The control group was treated with INSURE technique, or intubation alongside the application of surfactant and then extubation, followed by nasal continuous positive airway pressure ventilation;while the observation group was treated with LISA technique. The incidence of transcutaneous oxygen saturation (SpO2) decline and bradycardia during the administration were compared between the two groups, as well as the proportion of patients treated with PS (again) after treatment and mechanical ventilation within 72 hours. The mortality of children and the incidence of pneumothorax and bronchopulmonary dysplasia (BPD) were recorded. Results The incidence of SpO2 decline (17.5%) and bradycardia (7.5%) in the observation group were significantly lower than corresponding 50.0% and 27.5% in the control group (both P<0.05). The proportion of patients received mechanical ventilation after treatment (15.0%) and the incidence of BPD (7.5%) in the observation group were significantly lower than corresponding 35.0% and 20.0% in the control group (both P<0.05). There were no significant differences in the incidence of PS reuse (37.5% vs 45.0%) and pneumothorax (7.5% vs 12.5%), and the mortality (5.0% vs 7.5%) between the two groups (all P>0.05). Conclusion The application of LISA in the treatment of neonatal respiratory distress syndrome can effectively reduce the incidence of post- extubation mechanical ventilation and BPD, which has a good clinical value.
作者
赵宏
王昌燕
裴怀腾
ZHAO Hong;WANG Chang-yan;PEI Huai-teng(Department of Neonatology,China XD Group Hospital,Xi'an 710077,Shaanxi,CHINA)
出处
《海南医学》
CAS
2019年第20期2671-2673,共3页
Hainan Medical Journal
关键词
新生儿呼吸窘迫综合征
早产
肺表面活性物质
经鼻持续气道正压通气
Neonatal respiratory distress syndrome
Premature delivery
Pulmonary surfactant
Nasal continuous positive airway pressure ventilation
